Catholic dominance over hospitals endangers women

A public-health giant

Catholic hospitals provide care for 1 in 6 patients in the United States; they are, collectively, the largest not-for-profit health care provider in the country. As secular hospitals merge with Catholic ones, many health care organizations and the communities they serve are on edge. In Washington state, for example, mergers mean that nearly half of hospital beds are in facilities controlled or influenced by the church, and in many regions a Catholic hospital is the sole provider. Nationwide, Catholic health care providers grew by 16 percent from 2001 to 2011. The number of secular nonprofit hospitals dropped by 12 percent in that period; the number of public hospitals fell by 31 percent.

Catholic health care providers are bound by the Ethical and Religious Directives for Catholic Health Care Services, a document issued by the U.S. Conference of Catholic Bishops that governs how health care providers should deal with reproductive issues, end-of-life care, the “spiritual responsibility” of Catholic health care and a variety of other concerns. The range of women’s health care options that Catholic facilities offer is limited — sometimes, like when a pregnancy goes wrong, to a deadly degree. And while most doctors have an ethical obligation to inform patients of all their options, Catholic facilities routinely refuse to offer even abortions necessary to save a pregnant woman’s life; their doctors are also barred from telling a patient with a nonviable pregnancy that there are other, often safer options available elsewhere, lest the patient seek care at another facility. (LGBT patients may also run into problems, whether it is with hormone therapy for transgender patients or simply the right of married same-sex partners to be treated as next of kin in making health care decisions).

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But Catholic hospitals receive enormous amounts of state and federal funding, in the form of large tax exemptions, Medicare and Medicaid dollars and specific grants for certain types of care. In 2011, Catholic hospitals received $27 billion in public funding, not including tax breaks — nearly half their revenue. Catholic hospitals employ and serve populations that are not predominantly Catholic. One-fifth (PDF) of physicians at religious hospitals reported facing a “clinical ethical conflict” in which their medical judgment was at odds with the hospital’s religious policy. Because Catholic hospitals receive public funds and care for a diverse population, they should have a duty to serve the actual health needs of their patients and the ethical obligations of their staffs over church dogma.

Instead, they put the dogma first. As a result, rape victims are routinely refused emergency contraception in Catholic hospitals. Women with life-threatening ectopic pregnancies, which are easily ended by a shot of methotrexate or a minor surgery, often find an entire fallopian tube unnecessarily removed — decreasing the odds of future pregnancy — if they seek care at a Catholic facility. And, as Means discovered, even in life-threatening emergencies, Catholic hospitals regularly refuse to terminate pregnancies and may face penalties, including removal of church-affiliated status, if they do so to save the life of the mother. In one case in Arizona, a pregnant mother of four went to a Catholic hospital’s emergency room with a condition so life-threatening that her chances of imminent death without an abortion were nearly certain. She was too ill to transfer to another facility, so the hospital’s administrator, a nun, approved an emergency termination. The woman lived. The nun was excommunicated. Her standing with the church was eventually restored, but the hospital lost its 116-year affiliation with the Catholic Church.

Refusing to provide female patients with a full range of reproductive care is discrimination. Intentionally providing substandard care when safer, better options are available is monstrous. It means women see their bodies damaged, their fertility impaired and their lives threatened. Low-income women and women in rural areas face the greatest hardships, since they may have no other option for care except a Catholic hospital. Rural living means there may not be another hospital for miles. Poverty means finding a provider that accepts Medicaid and is nearby; distance equals more gas money or more time on public transportation and off work. For many women, the closest abortion clinic is hundreds of miles away. Religion should not be an excuse for public health institutions to discriminate so broadly and do such harm.

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In reality, the so-called religious freedom of health care providers to accept massive federal and state funding while refusing to provide comprehensive health care violates women’s bodies and endangers their health. The grossness of this discrimination and the dangers it poses become transparent in neighborhoods affected by mergers, where women in need of emergency care may not have the option of seeking out a non-Catholic hospital. If the Catholic Church sees women as second-class citizens and wants to continue barring them from positions of power within the church while fruitlessly demanding they abstain from contraception use and premarital sex, that is the church’s prerogative. But if they are working in the health care space, they must provide the most appropriate, humane and effective health care. Even to women

http://america.aljazeera.com/opinions/2014/2/dangers-of-a-catholichospitaluntold.html